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NPI Code Detail

MEDICARE: ALFONSO ANGEL GOMAR MD

MEDICARE: ALFONSO ANGEL GOMAR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianM D036246LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700916152
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALFONSO ANGEL GOMAR MD
Provider Business Mailing Address
First Line : PO BOX 6725
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-0725
Country : US
Telephone Number : 888-808-6483
Fax Number : 410-721-2656
Provider Business Practice Location Address
First Line : 2114 GENERALS HWY
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-7488
Country : US
Telephone Number : 888-808-6483
Fax Number : 410-721-2656
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 03/07/2023

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